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Spinal fluid abnormalities in CFS

The human brain is bathed in the cerebrospinal fluid, a sample of which can be obtained by spinal tap. A sample of the fluid will reflect what is happening in the brain. The best method for measuring proteins in the spinal fluid is mass spectroscopy. Dr. Komaroff cited one study (Baraniuk J, et al.—refer to slide, Proteomic Markers in Spinal Fluid) which found specific “proteomic markers” (proteins) in one-third to one-half of CFS patients and none in healthy controls—a highly significant difference. These proteins are indicative of a low-grade inflammation in the brain, "that there is something that the immune system ...wants to get rid of, and this process is reflected by these proteins in the spinal cord."

Increased lactic acid in cerebral spinal fluid

A 2008 study demonstrated that many CFS patients also have elevated levels of lactic acid in their cerebral spinal fluid relative to healthy controls and patients with Generalized Anxiety Disorder (Mathew S, et al.— refer to slide, Lactate in Spinal Fluid in CFS: In vivo Proton MR Spectroscopy). The researchers involved with this study postulated that the cause of increased lactate could be oxidative stress, a condition that sets off a chain reaction in which isoprotanes (by-products of oxidative stress) decrease blood flow by constricting cerebral arterioles, which in turn, increase brain lactate levels. They also hypothesized that the lactic acid could be building up due to a secondary mitochondrial dysfunction, which itself can cause increases in anaerobic glycolysis and lactate.